# PEARSON DRUGS NO. 4, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114041134
- **Authorized official:** WALTER BRENT PEARSON (MANAGER)
- **Authorized official phone:** (318) 445-1488

## Contact information

- **Practice address:** 900 N 5TH ST, LEESVILLE, LA 71446-3544
- **Practice address phone:** (337) 239-4521
- **Practice address fax:** (337) 238-4957
- **Mailing address:** PO BOX 3640, PINEVILLE, LA 71361-3640
- **Mailing address phone:** (318) 619-1129
- **Mailing address fax:** (318) 473-2879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 870RC | LA | Yes |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 08/22/2020